Farooq Juveriya, Sana M M, Chetana P M, Almuqbil Mansour, Prabhakar Bhat Nagapati, Sultana Rokeya, Khaiser UmaimaFarheen, Mohammed Basheeruddin Asdaq Syed, Almalki Mutlaq Eidhah M, Mohammed Sawadi Khormi Amro, Ahmad Albraiki Salem, Almadani Moneer E
Department of Pharmacy Practice, Shree Devi College of Pharmacy, Mangaluru, 574142, Karnataka, India.
Department of pharmacology, Yenepoya (Deemed to be) University, Deralakatte, 575018, Karnataka, India.
Saudi Pharm J. 2023 Aug;31(8):101668. doi: 10.1016/j.jsps.2023.06.001. Epub 2023 Jun 9.
Multiple prescriptions for different medications may be needed for chronic conditions, increasing the risk of polypharmacy. The WHO defined polypharmacy as "the administration of many drugs at the same time or the administration of an excessive number of drugs". The primary goal of this study was to evaluate polypharmacy in patients with chronic liver disease and to identify potential drug-drug interactions associated with it. A cross-sectional study was conducted at a tertiary care hospital in Mangalore, Karnataka, for six months, from November 2020 to April 2021. The study involved 118 patients with chronic liver disease from various age groups. Data was gathered by analyzing patients' medical records kept on the ward and interviewing them individually. In admission and discharge prescriptions, polypharmacy was examined. Online interaction checkers from Drugs.com and Medscape were used to interpret potential drug-drug interactions. The SF-36 and Chronic Liver Disease Questionnaire were used to measure the quality of life. The data obtained were analyzed statistically to determine the significant correlation. The number of prescribed drugs was significantly correlated ( = 0.018) with the severity of liver disease in Child-Pugh categories B and C. Additionally, moderate polypharmacy reduced quality of life ( < 0.05), and the physical health category was significantly associated with disease severity ( < 0.05). Drug-drug interactions were found in 108 out of the 118 examined prescriptions, totaling 586 interactions in the admission list and 405 interactions in the discharge list. If the potentially serious main drug interaction identified in this study is not well monitored, it could lead to a serious, potentially fatal health condition. Despite being advised, safety is not always guaranteed by liver enzyme monitoring. Therefore, healthcare providers must take additional precautions to avoid inappropriate prescribing, minimize side effects, and ensure drug safety.
慢性病可能需要多种不同药物的处方，这增加了多重用药的风险。世界卫生组织将多重用药定义为“同时服用多种药物或服用药物数量过多”。本研究的主要目的是评估慢性肝病患者的多重用药情况，并确定与之相关的潜在药物相互作用。2020年11月至2021年4月，在卡纳塔克邦芒格洛尔的一家三级护理医院进行了一项为期六个月的横断面研究。该研究纳入了118名不同年龄组的慢性肝病患者。通过分析病房保存的患者病历并单独对他们进行访谈来收集数据。在入院和出院处方中检查多重用药情况。使用Drugs.com和Medscape的在线相互作用检查工具来解释潜在的药物相互作用。使用SF-36和慢性肝病问卷来衡量生活质量。对获得的数据进行统计分析以确定显著相关性。在Child-Pugh B级和C级肝病患者中，所开药物的数量与疾病严重程度显著相关（P = 0.018）。此外，中度多重用药会降低生活质量（P < 0.05），并且身体健康类别与疾病严重程度显著相关（P < 0.05）。在118份检查的处方中，有108份发现了药物相互作用，入院清单中有586次相互作用，出院清单中有405次相互作用。如果本研究中确定的潜在严重主要药物相互作用未得到良好监测，可能会导致严重的、潜在致命的健康状况。尽管得到了建议，但肝酶监测并不总能保证安全。因此，医疗保健提供者必须采取额外的预防措施，以避免不适当的处方，尽量减少副作用，并确保用药安全。
